1.What is an Arthroscopy ?

The term Athroscopy comes from two words, " Arthro" meaning joint and "Scopy" meaning observing or examining. So Arthroscopy is a technique which enables the operator to see inside a joint and if necessary, to take a biopsy or to carry an operation. The instrument Arthroscope is a small telescope that contains glass fibres and a series of magnifying lenses that beam a very bright light into the joint. The surgeon is able to look through the eye piece of the arthrocsope, or uses a video camera to see the inside of the joint.

2.What are the indications?.

Arthroscopy is used as a diagnostic as well as an operative tool.

The main indications are:

• To identify the problems inside the joint e.g. torn cartilage, loose bodies, intra- articular fractures, tear of ligaments etc.
• Confirmation of the diagnosis
• Biosy
• Lavage: just washing the joint with normal saline produces relief of pain for a remarkable period. specially in mild to moderate types of osteo-arthritis of the knee joint.
• Synovial lesions
• Articular cartilage lesions.

3.What are the joints where Arthroscopy is done ?

Today most joints can be examined arthroscopically like Knee, Hip, Shoulder , Elbow, Wrist, Ankle even smaller joint like Temperomandibular joint. In Nepal only Knee arthroscopy is being performed. This facility is available in Siddhartha Apollo Hospital Kathmandu. Besides, Knee Arthroscopy is being done by few Orthopaedic Surgeons in few Hospitals and Private Hospitals.

4.How the Arthroscopy is done?

The arthroscopy is usually performed as an out-patient procedure and the patients most of the time do not require hospitalization. This can be performed in local, regional or general anaethesia and is done with all under aseptic precaution. The skin of the knee is cleaned and the joint is distended with a fluid (normal saline).Through a small incision the arthroscope is inserted inside the joint The athroscopist explores the joint in a systemic fashion, guided by the image on the monitor. .The damage that is present is easily seen and is treated with very thin , small instruments inserted through separate small puncture wounds. A few types of surgeries can be done like removal of torn cartilage, removal of loose bodies, biopsies, removal of scar tissue, and abrading (rasping, grinding ) of raw bone surfaces. At the end of the procedure the joint is washed out with normal saline and the small skin wounds are sutured. Usually the patients go back home the same day.

DR. M. P. SHRIVATAVA
CONSULTANT ORTHOPAEDIC SURGEON
SIDDHARTHA APOLLO HOSPITAL
KAMALADI-PUTALISADAK
POST BOX - 1958
KATHMANDU, NEPAL.
Tel: +977-1-226959-61
Fax: +977-1- 426963
Tuesday, June 15, 1999